CN1703168A - Cryo-surgical apparatus and method of use - Google Patents
Cryo-surgical apparatus and method of use Download PDFInfo
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- CN1703168A CN1703168A CNA038238543A CN03823854A CN1703168A CN 1703168 A CN1703168 A CN 1703168A CN A038238543 A CNA038238543 A CN A038238543A CN 03823854 A CN03823854 A CN 03823854A CN 1703168 A CN1703168 A CN 1703168A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1477—Needle-like probes
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
- A61B2018/0231—Characteristics of handpieces or probes
- A61B2018/0262—Characteristics of handpieces or probes using a circulating cryogenic fluid
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B2018/1405—Electrodes having a specific shape
- A61B2018/1425—Needle
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Abstract
Cryosurgical apparatus includes an elongate cryoprobe (12) having a cooling portion and an electrically conductive first portion in the region of the cooling portion. A removable sheath having an electrically conductive second portion is received on the cryoprobe with its electrically conductive second portion spaced from the electrically conductive first portion of the cryoprobe. Electrical insulation is interposed between the first portion and the second portion. Coolant material supplied to the cryoprobe produces tissue freezing in the region of the cooling portion. Electromagnetic energy supplied to either the first portion or the second portion, while the other of such first portion or second portion is connected to ground, provides selective heating in tissue surrounding an iceball produced by the cooling portion to control the configuration of the iceball.
Description
Invention field
The present invention relates to be used for the cryoprobe apparatus of cryosurgery and other purposes.More particularly, the present invention relates to a kind of Cryosurgical device with enhancing ability of the configuration of the ice pearl of formation in the control tissue.
Background technology
Cryosurgery or freezing excision are the oldest a kind of in the localized heat excision technology.It originally developed in 19th century.It once was used to destroy and the interior deep tissues of control volume, as tumor.
In many clinical reports, once described and cryosurgical probe was used for cryosurgery or various benign and virulent tumors are cured in freezing excision.In addition, in the clinical report of laparoscopy and percutaneous, once described cryosurgical probe was used for cryosurgery or freezing excision.
In general introduction that is published in the general history that has proposed cryosurgery in the paper that is entitled as " cryosurgery " in " biomedical engineering annual review " 2:157～187 in 2000 well by Boris Rubinsky that is incorporated herein by reference and the mechanism that wherein relates to.
Cryosurgery or freezing excision are the methods on a kind of original position freezing tissue or surface, wherein transmit freezing following temperature by penetrating cryoprobe, and a kind of cryogen of circulation or coolant or cooling material are arranged in this cryoprobe.The tissue of rapid freezing this cryoprobe of vicinity of this cryosurgical probe, thus freezing necrosis or tissue die caused.Irreversible disorganization results from usually and is lower than-20 ℃ temperature, and cell death is by directly freezing, membranolysis, cell dehydration, cell protein degeneration and local hypoxic-ischemic cause.Huai Si tissue is absorbed by health or repels then.Before removing cryoprobe, can carry out repeatedly freezing and thaw.
This cryosurgery method has a plurality of basic shortcomings.At present, cryosurgery or freezing excision are mainly the open type surgical technic.Depend on the tumor size, the cryoprobe of 1.5～8 millimeters of one to eight diameters is placed in the destination organization.A kind of cryogenic substance (being generally liquid nitrogen or argon) circulates a few minutes by cryoprobe, to obtain the temperature less than-120 ℃.After for the second time freezing, cryoprobe is heated by circulation warm fluid or helium usually and removes, and pipeline is wrapped up with hemostasis.It is reported that behind freezing excision or cryosurgery, bleeding is common complication.Other complication comprises heating, renal failure, sepsis, the IC of sending out and leukocytosis.Other limiting factor comprises that cryoprobe sizes is big, to the damage of tissue of direct contiguous freeze space or ice pearl, and the size and dimension of the ice pearl that in tissue, forms.
For example, that describes in " the percutaneous ray cryosurgery of prostatic per-rectum ultrasonic guidance is extractd " that " cancer " of Onik and Cohen 1993 72 volume is 1291 pages is used for cryosurgical probe prostatic cryosurgery or freezing excision, and cryosurgery or freezing excising operation have been described in detail in detail.Cryoprobe or cryoprobe are placed in the prostate by the sleeve pipe that utilizes ultrasonic guidance to settle in advance.What increase prostatic irregularly shapedly requires specific ice pearl shape, so that treat this tissue fully.For fear of damage contiguous tissue or structure, utilize inculcating continuously of warm saline by being placed in the conduit in the urethra, prevented urethra, external sphincter and neck of bladder sphincteral be subjected to freezing.In addition, the cryosurgery of hepatic metastases or freezing excision propose different challenges.Different with former liver tumor such as hepatocarcinoma, the shape of hepatic metastases is irregular, and usually on bad position, thus, the contiguous tissue or the damage of structure are main worries.
Above-mentioned difficulties and the syndrome relevant with the surgery excising operation with current cryosurgical probe in the various optimum or virulent tissue of treatment have produced the requirement that improves the cryosurgery apparatus and method.
Brief summary of the invention
The present invention discloses a kind of cryosurgery device and the using method that can control the ice pearl configuration that forms in the tissue.
In one embodiment, an elongated cryoprobe has the first of the conduction of a cooling segment and in this cooling segment zone, energy conduction component positioning near this cryoprobe and with cryoprobe on the second portion of a conduction is arranged in the zone separating of first, and an electromagnetic energy source operatively is connected on this first and second part, this energy source can be operated and in the heating to tissue of the region generating of this ice pearl, thus the configuration of control ice pearl.
In one embodiment, these apparatus and method are such, and the tissue that is exactly electromagnetic energy by the ice pearl that forms around the cooling segment by cryoprobe transmits, and this energy adds tissue thermal proximity and that center on and helps to control the configuration of this ice pearl.
In certain embodiments, this device and/or method or can protect contiguous tissue or structure to avoid the hot injury by the tissue of selecting circumference, perhaps may since produce heat energy transmission and to around tissue induce additional hot injury.
In certain embodiments of the present invention, device that provides and/or method are used for controlling both energy total amounts of applying at contiguous tissue of energy of the heat energy that produces from this freezing mechanism or electromagnetic-energy, thereby influence the total amount of tissue die or tissue necrosis.
The accompanying drawing summary
Fig. 1 is the perspective view according to the part of the device of one embodiment of the present of invention, and this device has the cryoprobe that settle at an elongated center that is surrounded by a sheath;
Fig. 2 is the view that is similar to the cryoprobe of Fig. 1, and this sheath is removed among the figure;
Fig. 3 is the perspective view of the sheath that takes off from cryoprobe;
Fig. 4 inserts tissue and operation and forms the enlarged perspective of the distal portions of the cryoprobe apparatus of the ice pearl of configuration selectively;
Fig. 5 is substantially along the sectional view of the amplification of Fig. 1 center line 5-5 intercepting;
Fig. 6 is the far-end perspective view of another embodiment of the present invention;
Fig. 7 is the enlarged perspective of distal portions of the cryoprobe apparatus of an operation of expression heat rating example; And
Fig. 8 is the far-end perspective view of another embodiment of the present invention.
Describe in detail
Singulative " one ", " one ", " being somebody's turn to do " refer to one or more than one, unless other clearly indicated in context.For example, term " comprises a cryoprobe " and comprises one or more cryoprobes, and is considered to and the phrase equivalence that " comprises at least one cryoprobe ".
Term " or " refer to an independent element of the alternative elements stated or the combination of two or more elements.For example, phrase " radio frequency or microwave energy " refers to radio-frequency (RF) energy, microwave energy or radio frequency and microwave energy.
Term " comprises " and means " containing ".Therefore, " comprise A and B " and mean " containing A and B " and do not get rid of other element.
Term " near " refers to the close operator's of an instrument a part, and " far away " refers to the part away from the operator of this instrument.
Term " object " refers to human body and animal target.In certain embodiments, this is to liking people or other mammal.
With reference to accompanying drawing, more specifically with reference to Fig. 1～3 and Fig. 5,10 total expressions are according to a kind of device of one embodiment of the present of invention.This device comprises the sheath or the sleeve pipe 14 of an elongated cryoprobe 12 and a coaxial setting that centers on.This cryoprobe has a far-end 12a and the most close operator's near-end 12b.
This cryoprobe comprises an elongated hollow needle member 16, and the latter is closed and point at its far-end, and is opening at its near-end.The interior pipe 20 of an elongated coaxial arrangement is installed in parts 16.As seen in Figure 5, the end of pipe 20 that comprises Giaque-Hampson heat exchanger 21 and Joule-Thomson nozzle 22 is towards the closed distal of parts 16 and stretch out from the near-end of parts 16.Pipe 20 forms a cryogenic media supply line, and coolant or refrigerant can be supplied to cryoprobe 12 by this pipeline.Space that is arranged between pipe 20 outsides and parts 16 inwalls form one for cryogenic media by the near-end of parts 16 effusive return path.
As being clear that among Fig. 5, the pipe connectors as 24 indications operably are connected on the near-end of pipe 20, can be from supplying cryogenic medias with the 26 cryogenic media sources of representing by it.The adapter 30 that returns on near-end that operably is connected parts 16 forms a return path, returns cryogenic media source 26 or lead to hope for this cryogenic media to guide another zone of this cooling fluid to it.
Shown in arrow among Fig. 5, guide the far-end of cold probe 12 into by the pipe 20 that comprises Giaque-Hampson heat exchanger 21 and Joule-Thomson nozzle 22 from the cryogenic media of cold temperature source 26, flow out Joule-Thomson nozzle 22, towards distal portions as the parts 16 of expanding chamber, and towards the far-end 12a cooling of cryoprobe.The pipeline of fluid edge formation between pipe 20 and parts 16 returns and flows out these devices by returning adapter 30 then.
Secondly, parts 16 can be made (steel of using as surgical operation) with conductive material, and have one as shown in Figure 5 be connected in electric connector 32 on its near-end.As will be further described below, this makes these parts can operatively be connected on equipment electricity or magnetoelectricity, and conducts electric energy or electromagnetic energy between its near-end and its far-end.
Though here being described as usually, all make parts 16 with conductive material, make and between its near-end and its far-end, to conduct energy, but will be appreciated that, the each several part of parts 16 can be made with electrically non-conductive material, and only is that part of being close to the cooling segment of cryoprobe will have an expose portion that conducts electricity.Under these circumstances, between current-carrying part on the parts and electric connector 32, will extend suitable conductor, and make and to transmit electric energy between them.
The near-end of one deck electrically insulating material 38 coating members 16 and the major part between the far-end.As being clear that in Fig. 5, the near-end 12b of parts 16 can keep exposing slightly so that add adapter 32, and the distal portions of parts 16 keeps exposing.This electrically insulating material can be other polymer that a kind of non-conductive rubber, plastics maybe can shield the tissue of contiguous this insulant.
With reference to Fig. 3 and Fig. 5, sheath 14 is made up of a slender casing 46 by a far-end 46a and a near-end 46b.This sleeve pipe has a centre bore or cavity, and its size can be held slidably by parts 16 wherein and the electrically insulating material 38 of being correlated with thereof.Sleeve pipe 46 has one deck to cover the electrically insulating material 48 of its major part.Cover this telescopic electrically insulating material and can be similar to material therefor on the parts 16.The far-end and the near-end of sleeve pipe 46 do not have covering insulating material, but keep exposure, as shown in Fig. 3 and Fig. 5.
In the proximal part 46b of sleeve pipe 46, form an indenture 52.One be fastened on the mounting sleeve 40 can elastic bending interlocking gear 56 be positioned to disengageably engage detent 52 and sheath 14 remained on the cryoprobe 12 as illustrated in fig. 5.This interlocking gear is the spring that is biased in the position shown in Figure 5.Logical moving manually from indenture 52 these interlocking mechanisms of promotion, be easy to throw off this mechanism, and sheath 14 is sliped off from cryoprobe 12.
As shown in Fig. 1 and Fig. 5, this device has sheath 14, and this sheath is co-axially mounted on the cryoprobe 12 and by interlocking mechanism 56 and is held in place.In this position, the major part of the length of electrically insulating material 48 overlapping casing tubes 46 stays its distal portions 46a and exposes.Electrically insulating material 38 around the major part of the length of needle part 16 makes sleeve pipe 46 and parts 16 electric insulations.As being clear that among Fig. 1 and Fig. 5, electrically insulating material 38 longitudinally stretches out from the distal portions 46a of sleeve pipe 46.The far-end of parts 16 longitudinally stretches out from insulant 38 with from sleeve pipe 46, make parts 16 distal portions both electric storm reveal also that heat exposes.
Do to have circular cross-section though cryoprobe 12 and sheath 14 show, should be appreciated that other cross section also can accept.These cross sections can comprise ellipse, rectangle, triangle or other.
With reference to Fig. 5, thermocouple 60 that is installed in the sensing temperature in the cryoprobe 12 can be operated and measure the temperature of the distal portion office of this cryoprobe, and this information is sent to one uses T
PThe recording apparatus of expression.Equally, thermocouple 62 that connects with sleeve pipe 46 can be operated and the information of temperature in the relevant boot proximal end district is sent to T
CThe moisture recorder of expression.
Still with reference to Fig. 5, needle part 16 and sleeve pipe 46 are suitable for being connected on the device, are used for heat energy is provided to the interior tissue in zone of contiguous cryoprobe.In this illustrative embodiment, needle part 16 is connected on the electromagnetic energy generator 66 by electric connector 32, and the latter can be the electromagnetic energy generator of radio frequency (RF) generator, microwave generator or other suitable changeable frequency in illustrative embodiment.Sleeve pipe 46 is depicted as on the ground wire that operatively is connected electricity by its electric connector 50.In another embodiment, sleeve pipe 46 can be connected power generator and be connected on the cryoprobe 12 on the ground wire.
Commercial electromagnetic energy generator can be used for producing in this system the electromagnetic energy of desired radio frequency energy, microwave energy or other suitable changeable frequency.Professional in this field will be familiar with can being suitable for producing provide ice pearl configuration that control produces the type of electromagnetic energy of the result that wants and needs and the electromagnetic energy generator type of level.The electromagnetic energy that offers this device can be with modulation format or impulse form control.
Equally, the cryogenic substance source that is used for this system can be the cryogenic substance source that is applicable to any commercialization of this kind operation, and this is that the professional in this field is known.
The declarative operation of this device is sufficiently disclosed, the existing beginning with reference to Fig. 4, the far-end of device 10 inserts in the tissue 70 of the object that will cure.The sharp-pointed far-end of needle part 16 is convenient to insert.In this cryoprobe has inserted this tissue in the desired target location after, be fed to parts 16 from the cryogenic substance in cryogenic media source 26, make around and the zone of the cooling segment of contiguous cryoprobe in tissue be frozen into total as in the ice pearl shown in 72.
After this ice pearl begins to form, be supplied to the needle part 16 of conduction from the electromagnetic energy of the electromagnetic energy of generator 66 such as radio frequency energy or microwave energy or other suitable changeable frequency, and the sleeve pipe 46 of conduction is connected on the ground wire.The electromagnetic energy that is sent on the far-end of needle part 16 flow to the sleeve pipe 46 of ground connection from parts 16 by the tissue 70 of surrounding iceball 72, substantially shown in arrow among Fig. 4 74.By configuration contiguous and that be used to heat this tissue that centers on and control this ice pearl around the transmission of the electromagnetic energy of the tissue of this ice pearl, the control degree of icing the pearl configuration is to be produced by level and time that the tissue 70 by surrounding iceball 72 is sent to the energy of needle part 16 and sleeve pipe 46.
Known to the Technology professional, electromagnetic energy depends on frequency by the propagation of tissue.The operator will select a suitable frequency to produce configuration of ice pearl and will controlling of size to forming.
This cryogenic substance preferably can be cooled to tissue about 0 ℃～-180 ℃ or lower temperature range.
The electromagnetic energy that gives in tissue can make tissue be heated to 10 ℃～200 ℃ or higher temperature.
Temperature is cooled to-180 ℃ and temperature is heated to 200 ℃ though mentioned, but will be appreciated that, can control cryogenic media and the supply of cryoprobe be produced the suitable cryogenic temperature of organizing in the cooling segment zone to cryoprobe, and can be controlled from the electromagnetic energy of generator 66 by suitable supply the heating-up temperature of tissue.Be used for refrigerated chilling temperature and the used heating-up temperature of organizing will be selected by the operator, so that be suitable for this operation most.
An example of the temperature range that Fig. 7 illustration produces in centering on the tissue of this device during use.As seen in Fig., the temperature gradient in the tissue can be the scope of medium temperature from the about 200 ℃ high temperature in abutting connection with the low temperature of the pact-180 of this device low temperature part ℃ to the distance of being separated by with it therebetween.The thermograde that herein illustrates only is example.
Be used for refrigerated temperature and measure and be recorded in device T with the thermocouple 60 of needle part 16
POn.Equally, the heating-up temperature of being close to this device can be judged and is recorded in monitor T from the temperature reading of the thermocouple on the sleeve pipe 46 62
COn.
Only as an example, cryoprobe 12 can be any suitable length and diameter usually for selected program.In certain embodiments, the length of cryoprobe can be about 10～25cm, and diameter is about 0.1～0.8cm.The nonisulated distal portions 12a of cryoprobe 12 will stretch out about 2cm from the outer end of insulating cover 38.Insulating barrier 38 will be from the radially protruding about 0.5cm of sleeve pipe 46, and the distal portions 46a of the exposure of sleeve pipe 46 can be from its insulating cover 48 protruding about 2cm.But these are exemplary dimensions.Be used for that heat conduction and both parts of conduction and the size of expose portion can change for different embodiment and cooling and heating efficiency that selection is provided.
Another embodiment of Fig. 6 illustration wherein uses one second conducting element 80.Conducting element 80 comprises an elongated conductive component 82, and the latter has one to be used to insert the tip far-end 82a of tissue and the cover layer 84 of an electrically non-conductive material, the major part of the length of this cover layer cladding element 80, but stay the far-end 82a of exposure.Parts 82 are connected to ground wire as indication.
In the operation of device shown in Figure 6, cryoprobe apparatus 10 is inserted tissue to be treated as previously mentioned and is connected to suitably on cryogenic media source 26, generator 66 and the ground wire.Element 80 insert contiguous cryoprobes 12 and with its along in the laterally spaced tissue, and the expose portion of parts 82 is aimed at the cooling segment and the current-carrying part of the exposure of needle part 16 on request.
When the energy from generator 66 is sent to needle part 16, this energy will not only flow to the collar tube sub-assembly 46 of ground connection and the parts 82 that flow to ground connection shown in arrow 86 shown in arrow 74.Utilize parts 82 and near possible being placed in the cryoprobe but other similar conducting element laterally spaced with it, the electromagnetic energy that transmits by this tissue will be used for the configuration of further control by the ice pearl of cryoprobe 10 generations.
Another embodiment of Fig. 8 illustration wherein uses one second conducting element 88, is also referred to as dispersive electrode.Element 88 comprises the conductive plate of a ground connection.This plate can be settled facing to wherein using the subject's skin of this cryoprobe apparatus.
In the operation of device shown in Figure 8, cryoprobe apparatus 10 is inserted in the tissue to be treated and suitably is connected on cryogenic media source 26, generator 66 and the ground wire.Element 88 is positioned to one and is contacted with subject's skin to be treated in the suitably selected zone by the operator.When the energy from generator 66 is sent to needle part 16, this energy will not only flow to the collar tube sub-assembly 46 of ground connection shown in arrow 74, and will flow to grounded parts 88 shown in arrow 90.The electromagnetic energy that transmits between needle part 16 and parts 88 will be used for the configuration of further control by the ice pearl of cryoprobe apparatus 10 generations.
Though described this device as described above in illustrative configuration neutralization, will be appreciated that, also can use other form that works on request.For example, the cooling segment of this cryoprobe can be placed between the two ends of this device, and the conducting element that should expose can be settled towards the far-end of this device or at this far-end.But, importantly electrically insulating material is placed in the (electromagnetic energy that one of them acceptance comes from generator between two conductive components, and another is connected on the ground wire), make that the energy of heat tissue will be by flowing around the tissue that is extended by the formed ice of the cooling segment of this cryoprobe pearl.
Be used for producing suitable freezing and control ice pearl configuration method can by change (increase or reduce) thus the total amount that conduction that organize in this cryoprobe zone and thermal conduction characteristic influences tissue die or tissue necrosis and further enhancing.This can finish by various medicaments are introduced this tissue, and described medicament is to select on the basis of bio-compatibility, hot property and electrical property.These medicaments are known to this technology professionals.
So far the device of having described and the therapeutic effect of operational approach also can further strengthen by injecting the element wherein encapsulated the medicament that can be discharged by heat.The zone of this kind material being injected the tissue of contiguous this cryoprobe apparatus makes the heat that produces from electromagnetic energy generator can add the tissue of this ice pearl of thermal proximity, thereby discharges the medicament of encapsulation state, so that additional therapeutic effect to be provided.
Though described preferred embodiment and method herein, the Technology professional should be understood that, can change and revise and do not depart from spirit of the present invention as proposing in following claims.
Claims (62)
1. cryosurgery device comprises:
An elongated cryoprobe, this probe has the first of a near-end, a far-end, a cooling segment and a conduction, this cooling segment is suitable for being positioned in the tissue to be treated, and is operated to cools tissue, thereby forms an ice pearl when activating in this tissue;
An energy conduction element, this element is connected on the described cryoprobe, and the second portion of a conduction is arranged in a zone that separates with described first;
Be placed in the electric insulation part between described first and the described second portion; And
An electromagnetic energy source, this energy source is connected on one of described first and second portion by operative relationship, can operate the heat effect of region generating to organizing on described ice pearl, thereby controls the configuration of this ice pearl.
2. the device of claim 1 is characterized in that, described energy source comprises a radio-frequency (RF) energy generator.
3. the device of claim 1 is characterized in that, one of described first and second portion are connected on the described electromagnetic energy generator by operative relationship, and another of described first and second parts is connected on the ground wire.
4. the device of claim 3, it is characterized in that described second portion is connected on the ground wire, this device also comprises the conductive pin of a ground connection, this pin be suitable for described cryoprobe along being positioned in the tissue and being connected on the ground wire laterally spacedly, with the configuration of this ice pearl of further control.
5. the device of claim 4 is characterized in that, the distal portions of described grounding pin exposes, and electrically insulating material covers the other parts of described grounding pin.
6. the device of claim 1, it is characterized in that, described cryoprobe comprises an elongated conductive component, and described energy conduction element is around the part of described conducting element, and described electric insulation partly is positioned between described conducting element and the described energy conduction element.
7. the device of claim 6, it is characterized in that described conducting element comprises an elongated conductive and heat-conductive sheath, the latter coaxially centers on the part of described cryoprobe, the far-end of described conducting element exposes, and second layer electrically insulating material covers the remainder of this conducting element.
8. the device of claim 1 is characterized in that, also comprises a mechanism that is used for a kind of cryogenic media is offered described cryoprobe.
9. the device of claim 1 is characterized in that, described conducting element comprises an elongated sheath on the part that is positioned in described cryoprobe, and this sheath can be removed from described cryoprobe.
10. the device of claim 9 is characterized in that, comprises that also one is used for described sheath is fixed on the interlocking mechanism that can throw off on the described cryoprobe.
11. the device of claim 1 is characterized in that, also comprises a temperature sensor, this pick off can operate the temperature in the zone of described cooling segment of the described cryoprobe of perception.
12. the device of claim 1 is characterized in that, also comprises a temperature sensor, this pick off can operate the temperature in the zone of the described second portion of perception.
13. the device of claim 1 is characterized in that, described cryoprobe comprises the needle part of an elongated heat-conductivity conducting, and a kind of cryogenic media can feed in this needle part and freezing at the region generating tissue of this cooling segment.
14. the device of claim 1 is characterized in that, the first of described cooling segment and conduction is near the far-end of this cryoprobe.
15. the device of claim 14 is characterized in that, described energy conduction element comprises an elongated sheath that is installed on this cryoprobe, and the far-end of this cryoprobe is longitudinally protruding from described sheath, and the configuration of described far-end is made penetrate tissue.
16. the device of claim 15 is characterized in that, described sheath is installed on the described cryoprobe removably, and this device comprises that also one is used for described sheath is fixed on the interlocking mechanism that can throw off on the described cryoprobe.
17. the device of claim 15, it is characterized in that, described electrical insulator is positioned between described cryoprobe and the described sheath, and the distal portions of described insulator is longitudinally protruding from described sheath, and the far-end of described cryoprobe is longitudinally protruding from described insulator.
18. the device of claim 1 is characterized in that, also comprises the pin of a conduction, is used for described cryoprobe with ground connection along be placed in tissue laterally spacedly.
19. the device of claim 1 is characterized in that, also comprises the conducting element of a ground connection, is used for facing to wherein settling being settled by the skin of therapist of described cryoprobe.
20. a cryosurgery device comprises:
The elongated cryoprobe that one near-end and a far-end are arranged, described far-end is suitable for being placed in the tissue to be treated, and operates the next ice pearl that forms in this tissue when activating, and described far-end has the first of a conduction;
An energy conduction element that is connected on the described cryoprobe, this element have the second portion of a conduction on a position that separates near described near-end and described first; And
Be positioned in the electrical insulator between described first and the described second portion;
Described first and second parts are suitable for that electromagnetic energy source with a heat tissue is operatively connected and in the heating to tissue of the region generating of described ice pearl, thereby control the configuration of this ice pearl.
21. the device of claim 20, it is characterized in that, described cryoprobe comprises an elongated conductive component, and described energy conduction element is around the part of described conductive component, and described electrical insulator is positioned between described conductive component and the described energy conduction element.
22. the device of claim 21, it is characterized in that, described conducting element comprises an elongated sheath that coaxially centers on the part of described cryoprobe, and the far-end of described conducting element exposes, and second layer insulant covers the remainder of this conducting element.
23. the device of claim 20 is characterized in that, described conducting element comprises an elongated sheath above the part that is positioned in described cryoprobe, and this sheath can be removed from described cryoprobe.
24. the device of claim 23 is characterized in that, also comprises the interlocking mechanism that can throw off, is used for described sheath is fixed on described cryoprobe.
25. the device of claim 20 is characterized in that, also comprises a temperature sensor, this pick off can operate the temperature in the described remote area of the described cryoprobe of perception.
26. the device of claim 20 is characterized in that, also comprises a temperature sensor, this pick off can operate the temperature in the described second portion of the perception zone.
27. the device of claim 20, it is characterized in that, described cryoprobe comprises an elongated heat-conductivity conducting needle part, and a kind of cryogenic media can feed in this needle part and produce in this remote area and organize freezingly, and a shelf is connected on the near-end of this cryoprobe.
28. the device of claim 27 is characterized in that, described energy conduction element comprises an elongated sheath, and its size can be installed on the described pin, and the far-end of described pin is longitudinally protruding from described sheath.
29. the device of claim 28 is characterized in that, also comprises the interlocking mechanism that can throw off, is used for described sheath is fixed on described cryoprobe.
30. the device of claim 28 is characterized in that, described electrical insulator is positioned between described pin and the described sheath, and the distal portions of described insulator is longitudinally protruding from described sheath, and the far-end of described pin is longitudinally protruding from described insulator.
31. the device of claim 20 is characterized in that, described cryoprobe comprises an adapter, and this adapter is suitable for being connected to the mechanism that is used for providing to described cryoprobe a kind of cryogenic media by operative relationship.
32. a cryosurgery device comprises:
The elongated cryoprobe that one near-end and a far-end are arranged, described cryoprobe comprises an elongated needle part, wherein can introduce a kind of cryogenic media, described far-end is suitable for being positioned in the tissue to be treated, and operation comes to form an ice pearl in this tissue when activating, and described far-end has the first of the conduction of an exposure;
An energy conduction element, comprise an elongated sheath that coaxially centers on this cryoprobe, and the described far-end of this cryoprobe stretches out from described sheath, described sheath is connected on the described cryoprobe removably, and the second portion of the conduction of an exposure is arranged on a position that separates near described near-end and described first;
A ground floor electrically insulating material that is positioned between described first and the described second portion; And
Some parts that covers described energy conduction element but not the second layer electrically insulating material of described second portion;
Described first and second parts be suitable for one organize heating energy source to be operatively connected, with transmitting tissue's heat energy by tissue around described ice pearl, thereby control the configuration of this ice pearl.
33. the device of claim 32, it is characterized in that, described ground floor electrical insulator is positioned between described pin and the described sheath, and a distal portions of described insulator is longitudinally protruding from described sheath, and the far-end of described pin is longitudinally protruding from described insulator.
34. the device of claim 32 is characterized in that, also comprises the interlock that can throw off, is used for described sheath is fixed on described cryoprobe.
35. the device of claim 32 is characterized in that, also comprises a temperature sensor, this pick off can operate the temperature in the described remote area of the described cryoprobe of perception.
36. the device of claim 32 is characterized in that, also comprises a temperature sensor, this pick off can operate the temperature in the described second portion of the perception zone.
37. the device of claim 32 is characterized in that, described cryoprobe comprises an adapter, and this adapter is suitable for being connected to the mechanism that is used for providing to described cryoprobe a kind of cryogenic media by operative relationship.
38. the device of claim 32 is characterized in that, described energy source comprises a radio-frequency (RF) energy generator.
39. the device of claim 38 is characterized in that, one of described first and second parts are connected on the described radio-frequency signal generator by operative relationship, and another of described first and second parts is connected on the ground wire.
40. the device of claim 39 is characterized in that, described second portion is connected on the ground wire, this device also comprises the conductive pin of a ground connection, this pin be positioned in described cryoprobe along in the laterally spaced tissue, and be connected on the ground wire, with the configuration of this ice pearl of further control.
41. the device of claim 40 is characterized in that, the distal portions of described grounding pin exposes, and electrically insulating material covers the other parts of described grounding pin.
42. a cryosurgery device comprises:
An elongated cryoprobe, this probe has a near-end, a far-end, the first in the conduction of a cooling segment on the described cryoprobe and an exposure in described cooling segment zone, this cooling segment is suitable for being positioned in the tissue to be treated, thereby and when activating operation will organize cooling one of formation in this tissue to ice pearl;
An energy conduction element is suitable for being positioned in the tissue that is close to described first and is spaced from, and this transport element has the second portion of the conduction of an exposure; And
The electromagnetic energy source of a heat tissue, this energy source is connected on one of described first or described second portion by operative relationship, and can operate at the heat effect of described ice pearl region generating to tissue, thereby controls the configuration of this ice pearl.
43. the device of claim 42 is characterized in that, is not that another that be connected described first on the described electromagnetic energy source or second portion is suitable for being connected on the ground wire.
44. the device of claim 42 is characterized in that, described electromagnetic energy source comprises a radio-frequency signal generator.
45. a method that is used for controlling the configuration of the ice pearl that forms at tissue by a cryoprobe may further comprise the steps:
Provide one the cooling segment of a heat conduction and the cryoprobe of a first of conducting electricity are arranged;
In the zone that separates with described first, provide one to have, and electrical insulator is positioned between described first and this second portion around the element of the second portion of the conduction of the part of described cryoprobe;
This cryoprobe is inserted in the tissue to be treated;
Activate this cryoprobe and in the tissue of contiguous this cooling segment, form an ice pearl;
On the selected electromagnetic energy source that is connected a heat tissue in described first and the second portion, and electromagnetic energy offered described selected one, so that in described ice pearl zone, produce heating to tissue.
46. the method for claim 45 is characterized in that, this electromagnetic energy source is a kind of radio-frequency (RF) energy generator.
47. the method for claim 46 is characterized in that, also comprises described selected one is connected on the described radio-frequency (RF) energy generator and another is connected to step on the ground wire.
48. the method for claim 47 is characterized in that, also comprise from described selected one with radio-frequency (RF) energy through around the organized delivery of described ice pearl to another, thereby add the tissue of this ice pearl of thermal proximity and control the configuration of this ice pearl.
49. the method for claim 48, it is characterized in that, further comprising the steps of: with one second conducting element insert with described cryoprobe along in the laterally spaced tissue, described second element is connected on the ground wire, and make the tissue of radio-frequency (RF) energy between described selected one and described second element, thereby further control the configuration of this ice pearl.
50. a method that is used for controlling the configuration of the ice pearl that forms at tissue by a cryoprobe may further comprise the steps:
A cryoprobe that the far-end of one conductive and heat-conductive is arranged is provided;
A conducting element is provided;
This cryoprobe is inserted in the tissue to be treated;
In the tissue that this conducting element is inserted the far-end of contiguous this cryoprobe and be spaced from;
Activate this cryoprobe and in described tissue, form an ice pearl;
Selected one in the described far-end of this cryoprobe and the described conducting element is connected to one and organizes on the heat energy source, and will organize heat energy to offer described selected one, to heat the tissue in the described ice pearl zone.
51. the method for claim 50 is characterized in that, this tissue heat energy source is a kind of electromagnetic energy generator.
52. the method for claim 51 is characterized in that, comprises also that with described selection one is connected on the described electromagnetic energy generator and the far-end of described cryoprobe or in the described conducting element another are connected to the step of ground wire.
53. the method for claim 52 is characterized in that, also comprise from one of described selection with electromagnetic energy through around the organized delivery of described ice pearl to another, control the configuration of this ice pearl with the tissue that adds this ice pearl of thermal proximity.
54. the method for claim 50 is characterized in that, also comprises selected improved chemical is injected the tissue of contiguous this cryoprobe to change the step of organizing the heat energy transport properties of this tissue that is injected into.
55. the method for claim 48 is characterized in that, also comprises the step of some elements being injected the tissue of contiguous this cryoprobe, and the medicament of sealing is arranged in these elements, when being heated, these elements are discharged into this kind medicament in the tissue.
56. the method for claim 50 is characterized in that, this electromagnetic energy source comprises a radio-frequency (RF) energy generator.
57. the method for claim 50 is characterized in that, this electromagnetic energy source comprises a microwave energy generator.
58. the method for claim 50 is characterized in that, this electromagnetic energy source comprises the power generator of a changeable frequency.
59. the method for claim 50 is characterized in that, produces 0 ℃～-180 ℃ chilling temperature when activating described cryoprobe in tissue.
60. the method for claim 50 is characterized in that, provides the step of heat energy to produce 10 ℃～200 ℃ heating-up temperature in tissue.
61. the cryosurgery device in the adjacent tissue that is positioned in the curee, this device can operate be used for this tissue produce from abutting connection with being low to moderate of this device about 0 ℃～-180 ℃ to the tissue regions that separates with this device up to 10 ℃～200 ℃ thermograde.
62. the method for claim 61 is characterized in that, this heat scope can activate heat sensitization compound and/or the medicament in the tissue.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
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| US10/213,568 | 2002-08-06 | ||
| US10/213,568 US6858025B2 (en) | 2002-08-06 | 2002-08-06 | Cryo-surgical apparatus and method of use |
| PCT/US2003/021269 WO2004012616A1 (en) | 2002-08-06 | 2003-07-07 | Cryo-surgical apparatus and method of use |
Publications (2)
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| CN1703168A true CN1703168A (en) | 2005-11-30 |
| CN1703168B CN1703168B (en) | 2010-05-26 |
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|---|---|---|---|
| CN038238543A Expired - Fee Related CN1703168B (en) | 2002-08-06 | 2003-07-07 | Cryo-surgical apparatus |
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| Country | Link |
|---|---|
| US (2) | US6858025B2 (en) |
| EP (1) | EP1545363B1 (en) |
| JP (1) | JP4365786B2 (en) |
| CN (1) | CN1703168B (en) |
| AT (1) | ATE530137T1 (en) |
| IL (1) | IL166661A (en) |
| RU (1) | RU2295931C2 (en) |
| WO (1) | WO2004012616A1 (en) |
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Also Published As
| Publication number | Publication date |
|---|---|
| RU2295931C2 (en) | 2007-03-27 |
| IL166661A (en) | 2008-04-13 |
| RU2005106278A (en) | 2005-09-20 |
| US7422583B2 (en) | 2008-09-09 |
| WO2004012616A1 (en) | 2004-02-12 |
| US6858025B2 (en) | 2005-02-22 |
| EP1545363A4 (en) | 2006-06-21 |
| CN1703168B (en) | 2010-05-26 |
| ATE530137T1 (en) | 2011-11-15 |
| US20040215178A1 (en) | 2004-10-28 |
| EP1545363A1 (en) | 2005-06-29 |
| IL166661A0 (en) | 2006-01-15 |
| AU2003248846A1 (en) | 2004-02-23 |
| EP1545363B1 (en) | 2011-10-26 |
| US20040210212A1 (en) | 2004-10-21 |
| JP4365786B2 (en) | 2009-11-18 |
| JP2005534405A (en) | 2005-11-17 |
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